Fleur-de-lis Abdominoplasty Guide

After massive weight loss, many individuals are left with loose abdominal skin. In some cases, a traditional abdominoplasty may not provide enough tightening. Fleur-de-lis abdominoplasty is designed for significant abdominal skin excess, achieving tightening in both vertical and horizontal directions. It is one of several types of abdominoplasty a person may consider.

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What is Fleur-de-lis Abdominoplasty?

This operation removes excess abdominal skin in two planes — vertical and horizontal — leaving an inverted T-shaped scar. The procedure allows for greater tightening than a standard abdominoplasty. In addition to skin removal, it may also involve:

  • Repair of separated abdominal muscles
  • Relocation of the umbilicus to a natural position
  • Removal of excess fat through suction-assisted lipectomy

Benefits of Fleur-de-lis Abdominoplasty

Potential benefits may include:

  • A flatter, firmer abdominal profile
  • Narrowing of the waistline
  • Improved fit of clothing
  • Removal of large amounts of loose skin
  • Some reduction of stretch marks, depending on their location

Disadvantages and Limitations

While effective, this procedure does have drawbacks:

  • Two scars remain: one horizontal scar low on the abdomen and one vertical scar along the midline
  • The vertical scar is more visible than with a standard abdominoplasty
  • Scars fade gradually over 12–18 months but do not disappear completely
  • Scar treatments (e.g., silicone dressings, laser therapy, or injections) may improve the appearance but cannot remove scars entirely

Who is a Candidate?

The fleur-de-lis is most suitable for those with substantial abdominal skin excess after major weight loss. The ideal candidate:

  • Has reached and maintained a stable weight for at least six months
  • Is in good physical and mental health
  • Is not obese
  • Does not smoke, or is willing to quit before surgery
  • Accepts the trade-off of permanent scars for removal of loose skin
  • Can take around three weeks off normal activities to recover

What Happens During Surgery?

  • Performed under general anaesthesia, the operation takes about three to five hours
  • Incisions include a vertical line down the midline and a horizontal line from hip to hip
  • Excess skin and tissue are excised
  • Separated abdominal muscles may be repaired
  • The umbilicus is repositioned so it appears centred after skin tightening
  • Suction-assisted lipectomy may be added for excess fat removal
  • The wounds are closed and dressings applied

When Are Results Visible?

  • Abdominal tightening is visible immediately, though swelling may obscure results
  • Swelling generally lasts six to twelve months
  • Scars start darker, then fade over time
  • Final results usually settle at around one year

Recovery and Hospital Stay

  • An overnight stay is common, though some individuals may remain in hospital for several days
  • Initial recovery takes three to six weeks
  • Showering is usually permitted after 24–48 hours, though sponge bathing may be easier early on
  • Pain levels vary but are generally moderate, managed with prescribed medication
  • Standing upright may be difficult for the first 7–10 days

Time Off Work, Driving, and Exercise

  • Work: Allow two to four weeks away from employment
  • Driving: Most people resume in three to four weeks, once safe mobility and reflexes return
  • Exercise: Avoid strenuous activity, lifting, or sports for 2–6 weeks. Walking is encouraged from the first day after surgery to reduce the risk of blood clots

Download our infographic: “15 Exercises to get the Best Body After an Abdominoplasty”

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Risks and Complications

As with all operations, risks exist. These may include:

  • Seroma (fluid build-up)
  • Hematoma (blood collection)
  • Infection or delayed wound healing
  • Fat or skin necrosis
  • Deep vein thrombosis or pulmonary embolism
  • Thickened or wide scars
  • Changes in skin sensation
  • Bleeding
  • Anaesthetic-related complications
  • Need for revision surgery if the outcome is unsatisfactory

Frequently Asked Questions

How can results be maintained?

Maintaining a healthy lifestyle, stable weight, balanced nutrition, and physical activity are key for long-term results.

What do the scars look like?

The fleur-de-lis leaves an inverted T-shaped scar. The horizontal scar is hidden in most underwear, while the vertical scar is visible on the midline. Scar length varies with each individual.

How long until scars fade?

Scars may take 12–18 months to mature. Silicone dressings, gels, and sometimes laser therapy can help improve their appearance.

Is it covered by health insurance?

  • If performed solely for cosmetic reasons, costs are usually not covered.
  • When there is a medical indication and eligibility for a Medicare Benefits Schedule (MBS) item number, some costs may be reimbursed.

What is the cost in Australia?

Costs vary depending on surgeon, hospital, anaesthesia, and whether abdominal repair or suction-assisted lipectomy is performed. The average range is $9,000–$29,000 AUD.

Can suction-assisted lipectomy be combined with Fleur-de-lis abdominoplasty?

Yes. Combining procedures is common. Suction-assisted lipectomy can reduce excess fat, make tissue dissection easier, and potentially reduce bleeding.